text:
We have sold almost 50% more properties than any other agent or solicitor firm across the PH1 and PH2 area this year.
HD Property Video Available. A simply superb and notably large 3 bedroom flat with accommodation spread over two floors and benefiting from gas central heating, double glazing, high-quality fixtures and finishings and its own private entrance on street-level. Having recently undergone a high degree of renovation and program of modernisation, the property has been completely transformed to create a bright and spacious home boasting many eye-catching features. The upgrading has included: new kitchen and shower room, new windows, new boiler and re-plastering of walls to name but a few. The property is entered into a small porch with double doors which leads into an impressive entrance hallway with space for coats and footwear and a winding staircase leading to the main accommodation. More >


text:
..I finally get hold of my online purchase.
I finally had a chance to post some update today. I've been busy running errands and assisting my younger sister in the past couple of days. Now, that my nephew was discharge from hospital I have more time doing my thing online. I do have some late sharing to do.
Anyway, few months ago I have reserved few stuff from an online store own by an online friend living in the US. The store is managed by her sister who is living in the country. The time when I reserve the items the package was on transit then but for some reasons I took six months before the package arrived. I was hopeless already but last week I got a message that my order is ready to ship.
My order includes:
White women's rubber- strap chronograph fashion watch, Orange Arizona Crop, Red Carpet Sally Hansen nail polish and Victoria Secret Perfume and Minty Lip shine.
I have tried the nail polish to my mother and sister earlier today and I love the color. I will be posting photos of me wearing the items I've purchased on my next post.

subset: commoncrawl


text:
Sched.com Conference Mobile Apps
This event has ended.
View the
official site
or create your own event →
Check it out
This event has ended.
Create your own
A MAZE. / Berlin 2016
5th International Independent Videogames Festival in Berlin,
April 20 to 22, 2016 – plus extra Family Day.
We're still adjusting and adding things to the schedule, so keep checking it in the next days for updates!
By Venue
or browse by date + venue
Game Exhibition
View analytic
, April 21 • 13:20 - 14:50
Hyper Talks – 10 talks, 5 minutes each: Anne B. J. Clausen & Simon Stålhandske, Brendan Lehman, Cukia Kimani, Elizabeth Maler, Evan Greenwood & Martin Kvale, Florian Veltman, Rob Davis, Sarah Hiebl, Suba Jarrar, Veve Jaffa
Sign up
log in
to save this to your schedule and see who's attending!
A series of 5-minute talks in rapid succession. Missing talk details coming soon!
* * * * *
Anne B. J. Clausen & Simon Stålhandske: Crowd Games
Things we consider when designing local multiplayer games for 50+ players.
* * * * *
Brendan Lehman: Mind Games
How to use brain synchronization to control video games.
* * * * *
Cukia Kimani: INDIE <3
A brief explanation of this worldwide phenomenon, indie love.
* * * * *
Elizabeth Maler: A Normal Lost in Translation Phone
A hypertalk about how players project hints of reality on entirely original fiction.
* * * * *
Evan Greenwood & Martin Kvale: Genital Jousting: From A MAZE. to A MAZE.
How to stumble into making a game (sort of) about anal sex. Content warning: this talk contains sexual content.
* * * * *
Florian Veltman: Tired of Saving the World
A case for more mundane stories in games.
* * * * *
Rob Davis: Design by Conversation
What can happen when you design games whilst eating pizza.
* * * * *
Sarah Hiebl: it is really awkward to make a game about your friends
Sarah Hiebl wanted to make a game about how wonderful her friends are, but that escalated quickly.
* * * * *
Suba Jarrar: Play to Learn!
There are no specific criteria to say the game is good or bad, yet games, which engage players and impact their learning, are super good ones!
* * * * *
Veve Jaffa: Games Would Do Anything For Love, But They Won't Do That (Please Stop Trying to Make Them Do That!)
Allowing games to exist beyond one-dimensional definitions creates better experiences for players and designers
Lorenzo Pilia
Program Manager, A MAZE.
Program manager for A MAZE. / Berlin festival. Founder of BerlinGameScene.com + Localmultiplayer.com. Organiser of Join – Local Multiplayer Summit and Talk & Play.
Anne Birgitte Jerichau Clausen
Game designer with a big love for local multiplayer games. Also, thinks screens and standard controllers in digital games are overrated. Currently doing tons of crowd game prototypes with my B(w)FF Simon Stålhandske. It will hopefully end out being our master's thesis soon.
Brendan Lehman
Brendan is director of Cingulate R&D, master in neuroscience, game designer, musician, and music festival curator based in Toronto and Sudbury, Canada.
Cukia Kimani
Born in Kenya. Raised all over Africa. Holds degrees in Computer Science, Maths, and Digital Arts. Programmer, with an affinity for game design. Winner of the inaugural A MAZE. Johannesburg Award for Boxer.
Elizabeth Maler
Elizabeth is leading three lives at once. By day she organizes indie games playtests with Play in Lab to understand why 90% of players can't open that damn door. In the evening she fights the patriarchy. By night, she works on her A MAZE. Award-nominated game, A Normal Lost Phone.
Evan Greenwood
Evan Greenwood is a game designer from Cape Town, South Africa. He last worked on "Broforce", a game that parodied hyper-masculinity. (Sort of) exploring anal sex seems like a logical next step.
Florian Veltman
Florian is a budding French games author focusing his work on interactive narration, who recently made the game Lieve Oma.
Martin Kvale
Martin Kvale is a sound designer from the fjords of Norway where he works on weird and delicious projects connected to games. He is here at A MAZE. this year as part of the team making Genital Jousting as well as doing a wicked DJ-set!
Rob Davis
Founder / Director, Playniac
Rob is a game designer and Creative Director of Playniac in London. His games include IndieCade-finalist race management sim International Racing Squirrels, globe-trotting crowd game Cat On Yer Head, award winning math game Anomaly X, and turn-based battler Insane Robots; coming to PC and consoles in 2017.
Sarah Hiebl
Sarah Hiebl studies 'Time based and Interactive Media' in Linz, Austria. Her work includes short films, zines (about dicks) and games.
Simon Stålhandske
An avid game jam attendee and the twisted mind behind games such as Setup.exe, NorthSouthEastWest, Cat and 30 other games you have never heard of. Right now struggling to finish master's thesis on crowd games with best worst friend DJScoretrick.
Suba Jarrar
Co-Founder, Limitless
Suba Jarrar is a content developer, game designer and eLearning specialist. Currently works for a local non-government organization NETKETABi in Palestine. The organization aims for community development, specifically in the field of education. As an eLearning expert she is responsible for the management of content development and eLearning projects at the organization. Suba is a certified instructional designer and has two MSc. in Science of...
Read More →
Veve Jaffa
Veve Jaffa is a bioluminescent creatrix of filmic and digital worlds, experimenting with conventional film and game genres to make wonderful, challenging, and more often than not, very gay stuff.
Thursday April 21, 2016 13:20 - 14:50
Revaler Str. 99, 10245 Berlin
Attendees (134)
View All →
A MAZE. / Berlin 2016
Apr 20
23, 2016
, April 20
, April 21
, April 22
, April 23
Berlin, Germany
Sort schedule by Venue
Urban Spree
Game Exhibition
Recently Active Attendees
Linsey Raymaekers
Simon Bachelier
Guillaume Noisette
Pepijn Willekens
Peter Maasen
Johannes Følsgaard
More →
Take a tour
or contact the
event organizer
for event questions.
event social networking
event mobile apps


text:
Yiwu Huanshuo Jewelry Firm
Information about the company tested and proven on-site.
Company-supplier verification services: China Credit Information Service (P.R.C.) Ltd. [CCIS (PRC)]
Business license (registration number): 330782601125502
Company Name: Yiwu Huanshuo Jewelry Firm
Country / Territory: China (Mainland)
Registered address: No. 77, Chengde Road, Choujiang Street, Yiwu, Zhejiang, China (Mainland)
Year of Incorporation: 2010
Authorized Legal Representative / CEO: Xianping Zeng
Legal Forms of Business: Individual Operation
Issuing Authority: Yiwu Administration of Industry and Commerce
Business Type: Trading Company
Operational Address: Room 403, Unit 3, Building 98, Chunhan 3rd Area, Yiwu, Jinhua, Zhejiang, China (Mainland)
Full Name of Applicant: Ms. Linda Zeng
Department of the Company: Foreign Trade Dept.
Position in company: Manager
You have worked with the company Yiwu Huanshuo Jewelry Firm? Do you think this company scams?
Please share your experience of cooperation with Yiwu Huanshuo Jewelry Firm in the comments:


text:
Get started today! Call 404-872-5338!
Flexible scheduling and freshly renovated studios- we will find the perfect strings teacher for you!
Callanwolde instructors have trained and performed professionally with their instruments and are well-versed in all aspects of musical education including violin, viola, cello, and bass. Each genre and style of music is offered for instruction so students can customize their own education with instructors in both private and group string lessons.
From performance techniques to professional practices to instrument skills, students can learn their instrument to accommodate all musical goals. The Gardener's Cottage on Callanwolde's historic grounds offer a piano in every room so students can be cross trained and accompanied to develop the student's musical education.
Private Lessons
Private string lessons are scheduled on an individual basis. Classes are offered for children as young as two years old. Lessons are held weekly at time increments of 30 minutes, 45 minutes, or 60 minutes. Students must confirm times and dates of courses with Callanwolde before registering and paying for lessons.
Monthly lessons available:
- 30 minutes: $115 members/$125 non-members
- 45 minutes: $180 members/$190 non-members
- 60 minutes: $230 members/$240 non-members
To register or for more information contact us at 404-872-5338 or firstname.lastname@example.com.
Click to call and book your private string lesson!
Scholarship Assistance
Callanwolde Fine Arts Center awards scholarships based on financial need and/or merit. Please visit our main Scholarships page here for scholarship applications and additional information.
About Callanwolde Fine Arts Center
Callanwolde was built in 1920 by Charles Howard Candler, eldest son of The Coca-Cola Company founder Asa Griggs Candler. The estate is located in the Druid Hills neighborhood of Atlanta and is on the National Register of Historic Places. The 12 acre estate contains a magnificent Tudor Revival style mansion, lush gardens, and several outer buildings. Click here to learn more about the history of Callanwolde.
Today, Callanwolde is owned by Dekalb County and is the home of Callanwolde Fine Arts Center. Callanwolde Fine Arts Center is a cultural community conservatory of the arts on a 12 acre campus. Callanwolde offers classes in the performing arts (music, music recording, dance, dance fitness), visual arts (painting/drawing, pottery, weaving/textiles, jewelry/metalsmithing, photography), writing, yoga, horticulture, culinary arts and more to students of all ages.
Need to buy or rent an instrument?
Callanwolde recommends the exemplary Atlanta Violins of Roswell for string instrument rentals and sales.


text:
FTC's Brill Backs Enhanced Consumer 'Right To Obscurity'
Brill, speaking at a U.S. Council for International Business event on growing the digital economy, said that last year's decision by the European Court of Justice, establishing in the European Union a "right to be forgotten," would be better classified as allowing a "right...
To view the full article, register now.
Try Law360 FREE for seven days
Already a subscriber? Click here to login


text:
Students going to university or college in 2017/18 can apply for their student finance now.
Apply early and get your money in time for the start of your course in 2017/18.
The SFE deadline dates are May 26th for New Students and June 23rd for Returners. Further information will be provided in due course for SFNI and New EU (all domiciles) applications.
Apply online at Student Finance England or get help from The Student Room.
Find out what finance and loans are available to you including information on bursaries and part time loans in our higher education support information section.


text:
You can still use the old method of cropping the walls to a single roof, used mainly to trim walls in an angle. If you are working in ArchiCAD 18 or older you already know that you can right-click the wall and crop the wall. However, if you are in ArchiCAD 19 or a newer
In ARCHICAD 19 these options are available at File > Save As (format: .bimx) Organizer-Publisher / Navigator In ARCHICAD 20 these options are available at File > Publish BIMx Hyper-model Organiser-Publisher / Navigator Notes: In ARCHICAD 20 the File > Save as command cannot be used for exporting BIMx Hyper-models any more. The Gallery options
The menu for Automatic Dimensioning for ARCHICAD 20 has moved to Document> Annotation > Automatic Dimensioning
Whether if you have added Notes to Doors or Windows in Plan or have assigned Note Sets, you can also work directly in the Schedule to add Notes instead. 4.1 Update or Create a Schedule (Cadimage>Doors and windows>Edit Schedule Settings). Remember to turn On the Notes in the schedule. 4.2. Select the Item (door or
If you have activated the Cover Fills on a Slab, you may want to display or not the fills in different stories. In order to achieve that, so to the Slab settings to the Floor Plan Display settings and change it to Custom
When you rotate a view like explained in this old article: http://blog.cadimage.com/2012/10/rotate-orientation/ You may find that the marker head of the details placed in plan are rotating with the view. A simple way to allow the marker to rotate is to check the standard Detail Marker to rotate with the view checking this simple settings:
One of the reasons why a Door or a Window may not be collating in a schedule could be related to the wall it's placed into. Go to the menu View>On Screen View Options> Wall and Beams Reference lines.
The Coverings work differently for ArchiCAD 18 compared to ArchiCAD 17 tool. The new way the covering works will determine of the Door or Windows openings are detected by the coverings or not. The recommended practice for ArchiCAD 18 would be to have the right renovation default filter before applying the covering, so please
If you place electrical symbols, you may want to keep the labels horizontal (readable). Go to Document>Set model view>Model view options> Set the orientation of labels to be 'locked'.
If you update your computer to the new system Maverick, you may have to Re install the driver for your License key, whether is a Wibu or a Codemeter. If you experience an error message 'no license found' you can download the drivers from Graphisoft's website: http://www.graphisoft.com/downloads/protection_key.html For more information: http://archicadwiki.com/OsxMavericks


text:
Documenting Hate / A project from ProPublica
Documenting Hate – ProPublica
Nobody knows how many hate crimes and bias incidents take place each year in America. Help us track them.
"Hate crimes and bias incidents are a national problem, but there's no reliable data on the nature or prevalence of the violence. We're collecting and verifying reports to create a national database for use by journalists, researchers and civil-rights organizations.
Resources for Victims and Witnesses of Hate Crimes and Bias Incidents:
If you were the victim of a crime, The Southern Poverty Law Center recommends you contact the police. The Human Rights Campaign has advice for victims on how best to do that
If you believe you were targeted because of your sexual orientation, gender identity or expression, or HIV status, you can contact Lambda Legal for legal assistance. You may also wish to reach out to a local LGBTQ anti-violence center for emotional support. The National Coalition for Anti Violence has a 24 hour hotline."


text:
Small Deck Designs
Friday, March 10th, 2017
When finding a theory to remain implemented internally renovating mission, that Trek Decking snapshot gallery should be a thing to consider. Along with featuring a delightful design, Trek Decking photograph collection additionally will show a house by having a pleasant atmosphere to help you to enjoy your own Monday event in the house easily. Your options of incredible styles can be bought in the following Trek Decking snapshot gallery, and you will find the idea you enjoy commonly. Always give consideration to look choices previous to picking out a topic of Trek Decking picture collection, ensure that you select the best idea. You will find the best dwelling pattern throughout Trek Decking snapshot collection for the reason that photos are compiled through the best property brands. You can aquire home while using the magnificent and additionally stunning glimpse, that Trek Decking image gallery will let you generate it. By using a lot of possibilities, this means you may have more opportunities to develop property you require.
When you have always dreamed of a house together with the advanced or classic glance, this amazing Trek Decking photograph collection can help you for many layouts proven tend to be multipurpose. By means of the concept of Trek Decking photograph gallery properly, you will be able to obtain a soothing and additionally relaxing setting on your property. In addition to Trek Decking pic stock may even make it easier to generate the necessary company feel comfortable by providing a striking appear and additionally tension relieving come to feel. You can pull a persons eye of everybody who devices your household by just working with some ideas from this Trek Decking photograph collection. Your Hi-Def quality of each one picture around Trek Decking photograph stock will likewise help in you to observe every characteristic within the layouts proven. You may look into much more image collection apart from Trek Decking snapshot stock to find some other uplifting options. If you would like have got images that made available from Trek Decking graphic gallery, tend not to feel concerned, you can actually acquire all images by way of free. Remember to take pleasure in Trek Decking pic gallery.
Friday, March 10th, 2017
Thursday, April 6th, 2017
Saturday, March 4th, 2017
Monday, April 10th, 2017
Sunday, March 5th, 2017
Monday, March 13th, 2017
Friday, March 3rd, 2017
Friday, March 3rd, 2017
Sunday, March 19th, 2017


text:
My first New York City job was in an office where everybody – even me, the new receptionist – got business cards. When I left the job three years later, I still had over half of the box I'd been given.
That box is still on my shelf. Is there any reason I should keep hanging on to the cards I was given? What are they, other than funny, curious relics of a job I've left behind?
How does one reuse old business cards? Any ideas? Or do they just head into the recycling bin?
…Hope everyone's week is moving swiftly toward the weekend.


text:
GBPUSD 29th January, 2015
Cable unfolded towards the downside as expected. However, it is yet to reach either count`s confirmation point and this is why we have to remain unbiased because both counts remain valid. Both main and alternate counts have equal probabilities. The main count expects that minute wave v pink has started unfolding towards the downside while the alternate count expects that wave (2) black is at its very early stages towards the upside. We should keep in mind that we will be able to determine an accurate target for wave v pink once it starts unfolding towards the downside. As always we will wait for either count`s confirmation point to be met to determine the highly probable count. Read More


text:
Topic of the Month- Teen Depression
Did you know that teen depression rates are rising around the world? One in five teens reports seriously considering suicide in the last year with girls reportedly considering it at twice the rate of boys. Unfortunately, boys more often complete the act. Driven by the pressures of the 24/7 online world, cyberbullying and worries about acceptance, teens with depression often withdraw, express irritability, act out or have episodes of panic or anxiety. While depression is often hidden, other teens may struggle more visibly with substance use, behavior problems or school troubles.
Effective help begins with a thorough assessment and an individualized treatment plan that addresses all aspects of the problem including family and peer factors as well as trauma and stress. Coordination with other providers such as pediatricians can be vital. Effective help can get teens back on track again. I have worked with teens as well as adults and couples for many years both in residential facilities and in outpatient clinics. I utilize CBT as well as EMDR, hypnosis and family therapy.
Here are some other specialty areas:
Addictive behaviors (substance abuse, gambling, food, codependency)
Trauma (Betrayal, domestic violence, childhood abuse,sudden death)
Relationships and Dating (especially for people having with bad past dating patterns)
Career Counseling (one-on-one guidance for first career decisions or for changing directions)
My approaches include both traditional psychotherapy and more rapid techniques such as cognitive-behavioral therapy, and EMDR. I am certified in hypnosis by the American Society for Clinical Hypnosis, a group that only trains licensed healthcare professionals. I am trained in Gottman Method therapy (Level 2) for working with couples, a technique based on extensive scientific research about couples. I am also available for coaching in person or via the web and provide psychological testing. The office is located in a large house with comfortable accomodations approximately one block off Franklin Road in Brentwood. My practice is independent although three other therapists are located in the building.
You can schedule an appointment right now by calling 615-337-6975. **Important: Please note that the correct address to use for navigation to the office is 309 Franklin Road, Brentwood, TN 37027. The office is located in a house on the Campus of Brentwood Methodist whose address is 311 Franklin Road. Unfortunately, that address cannot be accessed via computer navigation systems accurately. All staff at the Counseling Center in the house are private practitioners and not employees of the church.


text:
Paxar Technologies, established in 1991, is a Canadian firm that specializes in the sales and support of specialized design software for architecture, design, landscape and entertainment. Our two main titles are Vectorworks, a 2D designing and 3D modelling program, and Artlantis, a powerful rendering program. On our website, we offer you details about the products we sell, however it's worth noting here that what sets Paxar Technologies apart from other resellers is not so much the products we sell, but our approach to customer service. You may have heard it before, but at Paxar, we really do make customer satisfaction our number one priority.
This means whenever you call, you're going to be talking to someone who takes the time to ask the right questions, listens to you and ultimately finds the right solution for your needs. The way we see it, the sale is just the beginning of a relationship with us. Unlike other large resellers, at Paxar there's a human being available to help you with set up, day-to-day functionality, and/or training. Having done this since 1991, many of our customers have become very good friends. Although we love the business side of things, it's this last fact that makes us really proud!
Our Moral Compass and "Karma".
Chances are you won't find another software reseller that raises a topic like this, but we feel it's necessary to point out that in business, what goes around, does come around. We feel that words like "morals", "sincerity" and "integrity" are just as important as words such as "sales" and "margins". If you don't need it, we won't be selling it to you, period. In fact, we probably spend as much time talking clients out of something as we do explaining appropriate solutions. This earnest approach has built up what we value most at Paxar – long term relationships with our customers. If you'd like to learn more about how we roll, please pick up the phone or drop us a line any time – we'd love to chat about your needs.
Our Team
Teri Young
Sales, Communication, Marketing
and Technical Support
Trevor Pyne-Mercier
Sales, Communication and Marketing
Neil Barman
Training, Productivity and Technical Support Specialist
Rob Nykolaishen
Technical Support Specialist
Donna Dewdney
Administration, Order Support, Shipping,
Office Support and Database Management
Kelsey Cadwallader
Administrative Assistant, Social Media Management


text:
Reggie Fils-Aime, President of Nintendo of America, announced Bayonetta 2 exclusively for the upcoming Wii U home console. To accompany the announcement, Nintendo have released a trailer for the title.
Sequel to 2010's Bayonetta, released on PlayStation 3 and Xbox 360, the now announced title will be launching exclusively for Nintendo's Wii U platform. The news comes from Nintendo's press conference earlier today.
Fans may be disappointed to find themselves having to purchase an entirely separate system to the one that they played the original title on, but the situation could not have been avoided after SEGA dropped Bayonetta 2 earlier this year. Nintendo have taken on the publishing role for the title, securing themselves a significant exclusive and enabling Bayonetta 2 to even exist.
No other significant details have been released, with the exception that Platinum Games are still developing the title, and that Hideki Kamiya will return, this time as supervisor for the game. Hideki Kamiya is also currently working on another Wii U exclusive, The Wonderful 101, which is scheduled for later this year.


text:
Share your code.
Realm-js has a set of functionality that helps solving many problems or impediments related to Promises. Utilities live in this repository, apart from realm-js library. Typings included
npm install realm-utils --save
; // typescriptconst rutils = ; // es6
Iterates a list of promises (objects) consecutively. Respects promises if provided
var a = 1 2 3;realm;
And another example with optional Promise
Chain are very helpful when you have a logic flow, and you need to split it up, and keep you code clean. All methods are executed in strict order. You can call it a waterfall.
{ // I am the first one. And i set this.foo = "foo1" return "foo1"; } { // I am the second one, and i have "this.foo" at my disposal // And i set this.bar = "bar1" return "bar1"; } // I am the third one, and everyone will wait for me let self = this; return { // But i will not assign anything // Just have to resolve myself return } // I am the last to be executed, and i will assign this.hello = "world" return "world"; realm;
Executes methods in defined order. If a setter is defined, realm will assign the result into the instance of a class.
Formatting the output
You can format the output as well using "format" method.
{ return "foo1"; } { // I am still executed return "bar1"; } return hello : thisfoo realm;


text:
Capture your excitement and anticipation of your little one, as well as your body at its most feminine. The maternity session package is $999* when booked with a newborn session (newborn session package and pricing are below) or $1199* booked without a newborn session, of which a $150 deposit is required to reserve your session. Your maternity session includes:
The sweetest photo session ever! This session takes place, preferably, before your baby is two weeks old. Total package is $1599*, of which a $300 deposit is required to reserve your session. Your session will include:
Miss the two-week window for newborns? Not to worry, your baby will get cuter with each passing day! Total package is $1499*, of which a $200 deposit is required to reserve your session. This session is best for babies 3 weeks to 10 months old. Your session will include:
One-Year-Old Portrait Session -
Congratulations! You survived the first year! Total package is $1599*, of which a $300 deposit is required to reserve your session. This session is best for babies 11-14 months old and is split into three parts - 1. Family photos either in-studio or outside 2. Studio portraits of your baby, and 3. A cake smash! Your session will include:
Your children are growing much too quickly! Invest in family photography to remember them as they are today. Total package is $1499*, of which a $200 deposit is required to reserve your session date. Your package includes:
Custom Portrait Session for Couples, High School Seniors and Individuals -
Don't fit into one of the above buckets but still love my style? I am available for one-hour portrait sessions customized to your needs. These sessions are limited to two people and children ages 16 and older. Total package is $1199*, of which $150 is required to reserve your session date.
*Sales tax of 6% will be charged to Virginia residents.
**Travel distance limited to 20 miles from Ashburn, VA. Includes many Northern Virginia locations west of the Beltway - Ashburn, Brambleton, Sterling, Herndon, Chantilly, Aldie, Dulles, Leesburg, Centreville, Purcellville, Poolesville, Potomac Falls, Tysons Corner, Great Falls, McLean, Reston, Gainesville, Vienna, Fairfax, Burke, Manassas, Oakton, Haymarket, and Warrenton. All other locations, please inquire for travel costs.
Products -
I offer the following professionally-designed and printed photographic products:
High-quality prints - color-calibrated, printed on lustre paper, and mounted on sturdy art board to preserve and extend the life of the photograph. Prints start at $49 for a 5x7 and $69 for an 8x10.
Holiday cards and birth announcements - Choose from a gallery of designs and customize the card specifically for your photos. All cards are double-sided and printed on 130# card stock. Cards start at $199 for 25.
Gallery-wrapped canvases - Perfect for completing your rooms, these canvases have rigid support for both front and back to prevent stretching, come with perfect corners and with the hanger attached. Canvases start at $199 for an 11x14.
12x12 albums with lay-flat pages - Expertly crafted albums on no-glare, rigid, matte paper with a unique lay-flat design, the albums can be customized specifically for your photos and tastes. Albums start at $1499 for 10 spreads (20 pages).
Complete product pricing available upon request.
updated 1/8/18


text:
Starting a sailmaking business from scratch was always going to be a challenge but one I relished and what a journey it's been.
From the early days I knew I needed the right support from an accountant. I needed daily accounts and business metrics to really see how the sail loft was performing and where things had room for improvement; not something every accountant offers. I wish I'd found Cornish Accounting Solutions sooner to be honest. Paul and the team always go the extra mile to help and their support through Xero is always prompt and accurate.
I always recommend Cornish Accounting Solutions and absolutely love Xero and the control it has given me over my business.
Freeman Sails
Having three salons to run is a constant challenge but this is made easier by the support I receive from Paul and his team. A professional and nurturing accountant that I believe every successful business needs.
We were recommended to Paul by Barclay's Bank. It was the best decision we made to move across to Paul and his team. He is so pro-active and hands on helping us, we wouldn't be in the great position we are in now if it wasn't for all his help and support.
Our position has been completely vindicated thanks entirely to your knowledge, and your unshakable desire to stick to your principles, all of which is a measure of your integrity, something for which I am immensely grateful.
I can't imagine that anyone would not come away from your Wally Seminar evening inspired, motivated and energised to make a difference to their business.
It was a no-brainer to ask Cornish Accounting to get involved when we started building our business. It is one of the soundest business decisions we have ever made.


text:
Sunderland chairman Niall Quinn has revealed that the club's owner, Ellis Short, never thought about sacking Steve Bruce despite the team's recent winless run.
The Black Cats thrashed Bolton Wanderers 4-0 at the Stadium of Light on Tuesday to finally end a 14-match winless streak and ease concerns that they were being dragged into a relegation dog-fight.
However, Quinn says American billionaire Short is happy to keep Bruce at the Stadium of Light helm, saying:"Ellis is a big admirer of Steve and that has continued despite the disappointing run we've had.
"He knows that things rarely go smoothly in football and that there were a lot of factors such as injuries and suspensions and sometimes just the drop of the ball that hampered us during that time.
"But he has faith in me and my chief executive Steve Walton and he has faith in the manager we thought was the perfect person to take the club forward. So despite the results, the owner never once questioned whether we had the right manager.
"Ellis has been hugely impressed by Steve and in particular the way he's gone about recruiting players. Ellis sees that as such a vital part of the business and he likes the way that Steve has taken every care to make sure he makes as few mistakes as possible in that direction.
"I can assure you now that even if we don't win another game between now and the end of the season, Steve Bruce will be manager here next year. If we go down, he'll still be manager.
"I just feel he shares the same passion that the fans have, the owner has, we all have, and he does it in a diligent way. The way he carries himself and projects our club is everything we wanted. We're trying to make a step up in the toughest league in the world."


text:
2018 Memberships at Chase Hammond now available!
Stop in and secure your membership for the 2018 golf season! We have a variety of packages available to suit any golfer's needs.
Perks for members paying in full prior to April 1, 2018 include a 10% discount on all merchandise (food and beverage excluded), a 50% discount on range balls, and four complimentary greens fees guest passes for 9-holes.
Members also enjoy playing privileges at our sister course, Winding Creek Golf Club, in Holland, Michigan!
Please call (231)766-3035 or email firstname.lastname@example.com with questions.


text:
Our webinars are a great way to learn more about the benefits and features of KeyPay. They are free for anyone wanting to register.
We are currently running the following webinars for those interested in KeyPay:
This webinar is a great way to find out about the integration between KeyPay and QuickBooks Online and covers the basics of turning on the integration, setting up your business, adding employees and creating your first pay run. This free webinar runs every Monday from 10am AEST for about an hour


text:
Illustrate something for a banner size 600mm x 1600mm jobs
css icon loading size + select field after click button
I need advice on how to calculate effect sizes for large (45000) data set consisting of student test scores. The sample is non parametric and large, so I cannot use the usual tests for significance or effect size to determine differences.
Design Thoughts has been in the construction sector since many years. We have always been giving our clients the best in construction technology. We are continuously learning and innovating to satisfy your growing needs. The number of joyful faces of people staying in our designed buildings speaks about our services. Majority of our new customers come through referrals of our past customers.
want to design a2 size posters for my abroad education and migration services(3 posters) for 20 Australian dollars
i have 74 images that need to be crop to have the size of 1000X978 in very good quality. Its a crop job and its only jpeg files
...someone to build a program (ideally an app) that will be able to measure the size of an object using a phone camera. The idea would be, the user would place object in view of the camera, the user would point the camera at the object, and the app would identify a specific object to be measured (i.e. an object that is constant, e.g. a bottle shape or
I'm Tamara, I'm a personal trainer. I'm wanting to create 2 separate flyers One for Drop A Dress Size and another one still drop a dress size but tailored to an early risers club . My drop a dress size flyer I would like to appeal to mostly women, contain my logo, info needed on flyer is my contact details, Get started with T...
Need a Judge badge to use in social media (LinkedIn, Twitter & FB). I will give the event logo and Judge photo
I need some help with my business.
I have a plus-size women's boutique that is now going to be online. I need a logo that is bold, sexy and classy. One that stands out. The name of my boutique is CurvEssentials Boutique. My colors are rose gold and black/white. I've included something that I think would be nice but of course personalize and original to my brand. Would love to see ideas
increase wordpress upload file size...
Looking for a designer for our blog: [kirjaudu nähdäksesi URL:n] Review web site color and content please and send us your refereneces. graphics must be in web site colors and content
Hello, I am looking for someone that is comfortable formatting an image into a hi-res file that will be used for a website. I have included all formats of the logo here below. I will provide more details upon assignment but should only take 10-15 minutes max.
I am looking for One Side Flyer design in A4 size, I need flyer design in all possible formats like PSD, AI, EPS, PDF etc, Also don't place bid if you can't deliver first draft within 6 hours, I might will need unlimited changes, I need to finish this job today. Flyer design is about caravans.
I need someone to alter some image size.
Hi, I am looking to realise a document size guide for my clothes brand. It will be composed by text and drawing (pant / shirt) with size indication Please get back to me Best regards
regarding a online video course where the intro takes too much size. I need someone to find out why, and fix it.
I would like a photo realistic image of the man in the picture and his tshirt only . Not the background , only the person in the middle of the picture
I need help in writing a code to make the markers in scatter plot chart to change automatically depending on the values on the table. The sales volume dictates the size of the circle markers while the type of customer dictates the color.
I work in promotional products, and will need assistance with Merch T-shirt Designs. Would prefer front & back print. Have some of my own drawings... & some of my own designs to convert
I need someone to design an A-Frame sign for a Sticker Size: 25.50 x 16 needed in Photoshop format. Please write "A-Frame ready" in your response so I know you read my text.
It will probably require custom dev work. Must show the sample size result on the Typeform "Thank You Screen".
I need a flyer/brochure for business software product. I will give some product images ( I can also provide some adobe stock images as well) - Need to design it. If you have done similar work ( send me examples .. I definitely to see examples before I can give you the work) Brochure is for 2 to 3 pages - and needs to be punchy.
Build a screen that can be have a wireless connection between the other screens and a group of screens acts together. The size of the screen should be about 1 inch x 1 inch. The screen should be controlled be any mobile device. For further details you can contact me at : [Removed by Freelancer.com Admin - please see Section 13 of our Terms and Conditions...
...ecommerce websites. 28 photos of 84 pieces should be prepared on a white page 1280 X 1280 pixels. left 56 photos should be prepared on size 1280 X 700 Pixels with ecommerce's logo on white page. Consider I have ready cutted files of my products and designer doesn't need to work on photos ! size of them should be less than 300 kilobytes. I will send m...
Rekisteröidy tai kirjaudu sisään nähdäksesi tiedot.
Design me a brochure for printing on A4 size paper.
Our photowall is in the wrong size, its to small so the print do not look good. Its a very simple photowall that is very easy to fix for the person who have access to a designtool. price is fixed at 10 usd. Attached is also the logos used with watermark for the background, and also how we designed the photowall- please adjust the design if you think
Need 3-4 photos editing to remove back ground from two and to make the background uniform on the other so all photos look similar. Then need the new photos...remove back ground from two and to make the background uniform on the other so all photos look similar. Then need the new photos and the originals the same canvas size and at a quality for print.
You need to type the Document in microsoft word. I give the project to that person who have higher speed in typing...need to type the Document in microsoft word. I give the project to that person who have higher speed in typing. so if you type faster you can contact me. I have to much work for typing. so if you want to earn money in typing contact me.
Need 3-4 photos editing to remove back ground from two and to make the background uniform on the other so all photos look similar. Then need the new photos...remove back ground from two and to make the background uniform on the other so all photos look similar. Then need the new photos and the originals the same canvas size and at a quality for print.
I would like someone who can relate to the topic, write about what the ups and downs are of shopping online for plus size clothes and what would make for a better experience. Would like it to be relatable for people when they read it. 900 word minimum.
For a foreign language group, I need to make printable maps of 199 french villages using Google Maps or Openstreet maps. The maps need to be simple, clean, and clear with as many street names as possible for the size and they need to be high enough resolution to be printed clearly. Either in JPG/PNG format or PDF. Preferably a complete vector PDF. I
we have a Survey project all over India for 3 year just call me or chat : [Removed by Freelancer.com Admin]
...attached to understand. I have 1. One Banner 7000mm wide x 2850mm height - This will go in front of a shop, Banner should be visible from at least 25 metres away. Need to Show Products and Prices. Also need to have company logo, and a clearance sale logo showing a promotion/sale 2. I need 4 banners 1200mm wide x 1600mm high - Should hav...
I have a small png graphic and I need someone to create a new version sized 500 x 500 pixels for me. I want you to create a psd file for me - 500 x 500 pixels (do not attempt to simple resize this small images - I can do THAT!). I need a new image created. This should not take more than one hour and I will not pay for then $30 for<...
I think you might have got an idea from project title, It is just a single html page, it is already responsive but it doesnt fit well in some display sizes, you need to fix that, also you need to remove unnessesory javascript / css which are not being used and make page as light as possible, Thanks
I want professional animated gif. Details will be provided for interested designers. should provide source file (for ex PSD)
...get a Banner Made for our Hookah Bar Terrace on the rooftop. The Size of the Banner in 6000mm width and 1800mm Height. The Banner should depict the Hookah and smoking use of the Terrace. The colors should match with the over all restaurant design of Bombay Brau. We have Indian restaurant on 2nd and 3rd floor and the other posters as below are for...
I have a chat program coded in Delphi 7. On this program we have private messages and we have chat rooms. In the private messages, there is an issue where the font size setting such as small, medium and large are not changing at all. The font just remains small no matter the option you choose. This works in chat rooms, just not in private messages.
I need you to locate the size of a font in a wordpress theme/template and I need you to change the size of the font so that it is larger. I might need you to make multiple changes to the size of the font, I don't know what size I want this to be. Should not take longer than 1 hour. Bid no more than $35
Encrypt data using the bch algorithm
Hi. I have already Binance API PHP jaggedsoft on my server and I am trying to buy a coin, but I get the error that the Lot size is not correct. $coin = 'EOSBTC'; $trade_amount = '5.01234567'; $trade_price = '0,00162804'; $order = $api->buy($coin, $trade_amount, $trade_price); I want to buy every coin on Binance, so the Lot information should come
Project is to design a backdrop banner(8x12ft) which will be used in our seminars/events. Our speaker is a renowned business coach, investor and serial entrepreneur. He conducts these free business seminars to motivate and encourage more people to take up entrepreneurship. We need a backdrop banner which will be used in these seminars. The design should
Project is to design a backdrop banner(8x12ft) which will be used in our seminars/events. Our speaker is a renowned business coach, investor and serial entrepreneur. He conducts these free business seminars to motivate and encourage more people to take up entrepreneurship. We need a backdrop banner which will be used in these seminars. The design should
I'd like a flyer designed (post card size A6) that tells the story that customers can drop off their bike at the mechanic shop in the morning before their work commute and pick it up after work fixed. I need the service (drop-off > pick-up) to be immediately recognizeable from the graphics. The design should allow for text to be added. I will need
I have a fashion store and some filters load very bad. They're working but i want to improve them. So, i'm listing over 5k products that has filters, color and size. The loading page time with actual filters is over 40 seconds and i want to improve it by changing code or change it's structure. The online store is developed on a PHP custom platform
...uniform online. I need an application that can measure body size using camera : chest around, arm length, body length, shoulder wide, leg length, waist around Then, the application can store the data of the person measured and suggest proper size of the product to that person. - measure body size : chest around, shoulder wide, arm length, body length
Hi. I have already Binance API PHP jaggedsoft on my server and I am trying to buy a coin, but I get the error that the Lot size is not correct. I need some workaround or something else as soon as possible to fix that! $coin = 'EOSBTC'; $trade_amount = '5.01234567'; $trade_price = '0,00162804'; $order = $api->buy($coin, $trade_amount, $tra...


text:
The cold, snow and wind that hit the east coast Thursday reached down to the deep South, dumping up to a foot of snow on the Outer Banks of North Carolina and threatening citrus crops in Florida.
Wind was also a problem more than two dozen states issued wind chill warnings and advisories Thursday night.
Cape Hatteras received a full foot of snow, the largest accumulation since it got buried in Dec. 23, 1989, according to the National Weather Service (NWS) at Moorhead City, N.C.
"Due to high winds that accompanied the storm, exact measurements are difficult to obtain. Some unsheltered areas had very little accumulation, while other areas reported over 12 inches of snow. There were numerous reports of three to four foot drifts," according to the NWS at Moorhead City.
In Florida, West Palm Beach set a record low temperature early Friday morning 35 degrees.
Florida citrus growers were anxious about the effect of the frigid temperatures on their crops, which account for more than $9 billion in profits a year.
But Eric Boomhower, spokesman for the Florida Department of Citrus, said the fears wound up being unfounded.
"It looks like we came out of this one pretty lucky," he said. "It looks like Mother Nature had a little mercy on us."
Boomhower said major damage usually occurs when temperatures drop below 28 degrees for more than four hours. This didn't happen, he said.
Another reason citrus crops escaped the cold, Boomhower said, was the practice of spraying the trees with water, which then rapidly freezes, and provides a layer of insulation between the fruit and below-freezing temperatures.
At least one death in Indiana was attributed to the cold.
Related Topics:
Winter storms could spell doom for some churches
Bitter cold forecast for Northeast
Snow? Whoa! New England braces for even more!
More links on Winter Storms


text:
You are here
Why and Where do We Miss Significant Prostate Cancer with Multi-parametric Magnetic Resonance Imaging followed by Magnetic Resonance-guided and Transrectal Ultrasound-guided Biopsy in Biopsy-naïve Men?
European Urology, Volume 71, Issue 6, June 2017, Pages 896 - 903
Editorial comment from Piotr Chlosta: Study demonstrated that systematic and MRI-targeted biopsy miss clinically significant prostate cancer in different areas of the prostate gland. Systematic TRUS biopsy most commonly missed csPCa in anterior prostate, while MRI-targeted biopsy in dorsolateral area of the gland, whereas both techniques have difficulties in detecting apical lesions. These results may help in biopsy planning.
Knowledge of significant prostate (sPCa) locations being missed with magnetic resonance (MR)- and transrectal ultrasound (TRUS)-guided biopsy (Bx) may help to improve these techniques.
To identify the location of sPCa lesions being missed with MR- and TRUS-Bx.
Design, setting, and participants
In a referral center, 223 consecutive Bx-naive men with elevated prostate specific antigen level and/or abnormal digital rectal examination were included. Histopathologically-proven cancer locations, Gleason score, and tumor length were determined.
All patients underwent multi-parametric MRI and 12-core systematic TRUS-Bx. MR-Bx was performed in all patients with suspicion of PCa on multi-parametric MRI (n = 142).
Outcome measurements and statistical analysis
Cancer locations were compared between MR- and TRUS-Bx. Proportions were expressed as percentages, and the corresponding 95% confidence intervals were calculated.
Results and limitations
In total, 191 lesions were found in 108 patients with sPCa. From these lesion 74% (141/191) were defined as sPCa on either MR- or TRUS-Bx. MR-Bx detected 74% (105/141) of these lesions and 61% (86/141) with TRUS-Bx. TRUS-Bx detected more lesions compared with MR-Bx (140 vs 109). However, these lesions were often low risk (39%). Significant lesions missed with MR-Bx most often had involvement of dorsolateral (58%) and apical (37%) segments and missed segments with TRUS-Bx were located anteriorly (79%), anterior midprostate (50%), and anterior apex (23%).
Both techniques have difficulties in detecting apical lesions. MR-Bx most often missed cancer with involvement of the dorsolateral part (58%) and TRUS-Bx with involvement of the anterior part (79%).
Patient summary
Both biopsy techniques miss cancer in specific locations within the prostate. Identification of these lesions may help to improve these techniques.
Keywords: MRI, Prostate, Cancer, Biopsy, Location.
1. Introduction
Early detection of prostate cancer (PCa), with the intent to diagnose this disease in a curable state, currently leads to overdiagnosis which in turn can result in overtreatment [1]. Overdiagnosis is the main disadvantage of the present clinical standard where men with elevated serum prostate-specific antigen (PSA) levels and/or abnormal digital rectal examination undergo random systematic 10- to 12-core prostate transrectal ultrasound (TRUS)-guided biopsy (Bx). Other limitations of TRUS-Bx are underdetection and undergrading of clinically significant prostate cancer (sPCa) [2]. The number of cores and location for systematic sampling is a topic of debate [2], [3], and [4]. In Bx-naïve patients, generally accepted schemes for systematic sampling with TRUS-Bx are limited to the posterior peripheral zone, since most cancers are located in this region [2] and [4]. In the repeat Bx setting, most cancers are located in the anterior apex of the prostate [2], [4], and [5].
Multi-parametric MR imaging (mpMRI) can be used to reduce overdiagnosis and subsequent overtreatment [6]. mpMRI is able to detect sPCa (44–87%) in Bx-naïve mem and men with prior negative Bx. Furthermore, the high negative predictive value (63–98%) of mpMRI can be used to rule out sPCa [7], [8], and [9].
Although mpMRI is a promising technique, sPCa may be missed [10]. The interpretation of mpMRI can sometimes be difficult [11] and [12]. Current research has not focused on the location of cancers missed with mpMRI followed by MR-Bx. Knowledge of lesions being missed with MR- and TRUS-Bx is of clinical importance for diagnosis and treatment.
The purpose of this study is to identify the location of sPCa lesions being missed with MR-Bx and systematic TRUS-Bx in Bx-naïve patients at risk for PCa.
2. Materials and methods
2.1. Patient selection and imaging
This study was a retrospective analysis of stored MR-images of Bx-naïve consecutive patients with an elevated PSA level and/or abnormal digital rectal examination. All participants were enrolled by referral from urologists from July 2012 through January 2013 and were included in a previous prospectively study. However, no detailed data were published on the location of PCa [13].
All patients underwent mpMRI performed at 3T (Magnetom Skyra, Siemens Healthcare, Erlangen, Germany) according to the European Society of Urogenital Radiology prostate MR-guidelines [14]. mpMRI scans were scored independently by three readers (1 yr, 1 yr, and 19 yr of experience, respectively) using the Prostate Imaging Reporting and Data System version 1.0 (PI-RADS): from 1 (low) to 5 (high) according to the likelihood of sPCa being present [14]. Disagreements in PI-RADS were resolved by consensus.
2.2. Prostate biopsy
Both MR- and TRUS-Bx were performed in a second visit (Fig. 1). The standard diagnostic pathway consisted of systematic TRUS-Bx only for men who had a PI-RADS 1 or 2 reported on mpMRI. MR-Bx was performed in all patients with a PI-RADS 3–5 lesion on mpMRI, followed by systematic TRUS-Bx as well [15]. Each PI-RADS 3–5 lesions on mpMRI was biopsied using two to three cores. Seminal vesicles were sampled if suspicious for tumor invasion.
Flowchart describing the diagnostic pathways. All patients underwent both multi-parametric magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS)-guided biopsy. Patients with a Prostate Imaging Reporting and Data System (PI-RADS) ≥3 on multi-parametric MRI received MR image-guided biopsy in addition to TRUS biopsy.
During the MR-Bx session an axial diffusion weighted image (DWI) was acquired to relocate the cancer suspicious lesions (CSL) described on the diagnostic mpMRI. After needle insertion with MR-Bx two confirmation scans were acquired to verify the Bx location. TRUS-Bx was performed within 30 min after MR-Bx by a urologist blinded to the mpMRI and MR-Bx procedures. Any lesions seen on TRUS were targeted using the core for the relevant prostate zone.
2.3. Histopathology and risk stratification
All Bx specimens underwent evaluation by a urogenital-histopathologist blinded to the Bx strategy. Low-risk PCa was defined as either low-volume Gleason score (GS) 3 + 3 or 3 + 4 [9]. sPCa (= intermediate- and/or high-risk PCa) on MR- and TRUS-Bx was defined as a GS ≥4 + 3 or GS 3 + 4 (> 4 mm, or >1 positive core), or a GS 3 + 3 with a core length >6 mm. Furthermore, a GS 3 + 3 was defined as sPCa when more than one or two cores were positive on MR- and TRUS-Bx, respectively [13]. Thus, for lesions with a GS 3 + 3 the number of cores was modality specific.
2.4. Biopsy outcome
Results were described on a segment, lesion, and patient level.
- 1. Segment: Cancer locations were reported according to an adapted scheme as described by Barentsz et al [16] (Fig. 2). Two readers (MS and ML), both with 2 yr of experience in mpMRI of the prostate, determined in consensus the involved segments of the earlier defined CSL on mpMRI. Segments with suspicion on mpMRI (PI-RADS 3–5) were labeled as cancer when histopathologically proven with MR-Bx. With TRUS-Bx, six lateral and six medial samples from the posterior base, mid, and apex were obtained according to a standard scheme for initial Bx [2]. A positive Bx core was assigned to the corresponding segment(s). Segments of sPCa lesions (defined below) that were cancer positive on only one modality were considered as locations missed with the other modality. It should be noted that missed with MR-Bx can be the results of not identifying a CSL on mpMRI, or incorrect needle positioning during the MR-Bx procedure.
- 2. Lesion: TRUS-Bx: All cancer-positive segments (Fig. 2) that had a direct connection (neighboring segments in the anterior-posterior, left-right, or superior-inferior direction) were labeled as a single lesion. MR-Bx: All cancer-suspicious segments seen on the diagnostic mpMRI that had a direct connection were labeled as a single lesion when cancer was proven in at least one of these segments with MR-Bx. Lesions with ≥1 matching segment on MR- and TRUS-Bx were defined as the same lesion. To determine whether a lesions contained sPCa each lesion was evaluated separately by using the same criteria applied on a patient level. The maximum cancer core length (MCCL) and total cancer core length (TCCL) were determined to evaluate tumor volume.
- 3. Patient: Three groups were defined: patients with sPCa detected with MR-Bx alone (Group 1) or TRUS-Bx alone (Group 2) and with both techniques (Group 3).
Distribution maps of cancer positive segments in patients with significant prostate cancer on magnetic resonance image-guided biopsy (MR-Bx; left) and transrectal ultrasound-guided biopsy (TRUS-Bx; right). The anterior portion of the prostate was defined by a hypothetical line drawn 17 mm anterior from the posterior prostatic surface irrespective of prostate size, which represents the core length commonly used during TRUS-Bx [17].
SV = seminal vesicles.
The highest GS was determined on a patient and lesion level by combining histopathology from MR- and TRUS-Bx.
2.5. Statistics
One-way analysis of variance was performed to determine significant differences in age, PSA, or prostate volume. The proportions of cancer-positive segments were expressed as percentages, and the corresponding 95% confidence intervals (CIs) were calculated. The Fisher's exact test was performed to determine significant differences between groups. The Wilcoxon-signed rank test was used to determine significant differences between the MCCL and TCCL found with MR- and TRUS-guided Bx. Since patients served as their own control we used McNemar's test to detect a significant difference between the association of MR- and TRUS-Bx and outcome. A significant difference was considered when the p value was <0.05. The STARD (Standards for Reporting of Diagnostic Accuracy Studies) guidelines were followed to report the results. All analyses were performed with SPSS software (Version 20.0. Armonk, NY: IBM Corp.).
3. Results
Patient characteristics and histopathological outcome of the 223 included patients are shown in Table 1 and Table 2 and reported previously [13].
Patient characteristics of all included patients in whom cancer was not detected, and patients in which prostate cancer (PCa) was detected with magnetic resonance image-guided biopsy (MR-Bx) only (Group 1), transrectal ultrasound-guided biopsy (TRUS-Bx) only (Group 2), and both modalities (Group 3). The p value of one-way analysis of variance is given for the comparison between Groups 1–3
|All patients
|Significant PCa detected with:
|Included patients
|Negative on MR- and TRUS-Bx
|MR-Bx only (Group 1)
|TRUS-Bx only (Group 2)
|Both modalities positive
(Group 3)
|p value
|No. of patients (%)
|223 (100)
|81 (36.3)
|29 (13.0)
|15 (6.7)
|64 (28.7)
|Mean age, yr (SD)
|62.4 (7.4)
|59.6 (7.2)
|63.5 (7.0)
|62.7 (5.8)
|65.5 (6.7)
|Mean PSA, ng/ml (SD)
|5.9 (3.1)
|5.1 (2.2)
|6.7 (4.5)
|4.9 (1.0)
|7.1 (3.5)
|Mean prostate volume, cc (SD)
|46.8 (22.6)
|56.2 (24.4)
|40.0 (17.1)
|40.0 (10.1)
|39.0 (19.9)
PSA = prostate specific antigen; SD = standard deviation.
Histopathological biopsy outcome on a per patient level for MR- and TRUS-Bx for the total cohort of 223 men. Green shading indicates patients where magnetic resonance image-guided biopsy (MR-Bx) upgraded the Gleason score in relation to transrectal ultrasound-guided biopsy (TRUS-Bx). Analogous blue shading indicates patients where TRUS-Bx upgraded the Gleason score in relation to MR-Bx. A dark color represents a larger discrepancy between the two modalities
|No cancer
|Low-risk PCa
|Significant PCa
|Gleason 3 + 3 low volume
|Gleason 3 + 4 low volume
|Gleason 3 + 3 high volume
|Gleason 3 + 4 High volume
|Gleason ≥4 + 3
|No cancer
|Low-risk PCa
|Gleason 3 + 3 low volume
|Gleason 3 + 4 low volume
|Significant PCa
|Gleason 3 + 3 high volume
|Gleason 3 + 4 high volume
|Gleason ≥4 + 3
PCa = prostate cancer.
3.1. Patient basis
Combined histopathology from MR- and TRUS-Bx revealed PCa in 64% of the patients (142/223, 95% CI: 57–70%) and 48% (108/223, 95% CI: 42–55%) of the cases showed sPCa. MR- and TRUS-Bx detected sPCa in 42% (93/223) and 35% (79/223) of the patients, respectively, and this was statistically significant different (p < 0.0001). Low-risk cancer was significantly (p < 0.0001) more often detected with TRUS-Bx (21%, 47/223) compared with MR-Bx (3%, 6/223). In patients diagnosed with sPCa on MR- and TRUS-Bx upgrading of the GS was seen in 32% (35/108) with MR-Bx and in 22% (24/108) with TRUS-Bx, this was statistically significant different (p < 0.001).
In 15 patients sPCa was detected with TRUS-Bx only (three PI-RADS 3, seven PI-RADS 4–5, and in five patients no CSLs were seen on mpMRI). Retrospectively, in six out of 10 patients with a PI-RADS ≥3 the MR-Bx needle was not in the correct position and in one patient the images of the MR-Bx were not stored and thus not available for re-evaluation.
Anterior tumor involvement was seen in 41% (44/108, 95% CI: 31–50%) of the patients with sPCa.
3.2. Lesion basis
In total 191 lesions were found in 108 patients with sPCa (Table 3). From these lesions 74% (141/191, 95% CI: 68–80%) were defined as sPCa on either MR- or TRUS-Bx. MR-Bx detected 74% (105/141) of these lesions, and this was 61% (86/141) with TRUS-Bx (13% difference, 95% CI: 8–19%). In 37% (64/175, 95% CI: 30–44%) of the CSLs seen on mpMRI no PCa was found with MR-Bx. Reasons for failure of MRI to identify cancer lesions are shown in Table 4.
Highest Gleason score for all lesions (n = 191) detected with magnetic resonance image-guided biopsy (MR-Bx) and transrectal ultrasound-guided biopsy (TRUS-Bx) in patients with significant cancer (n = 108). Green shading indicates patients where MR-Bx upgraded the Gleason score in relation to TRUS-Bx. Analogous blue shading indicates patients where TRUS-Bx upgraded the Gleason score in relation to MR-Bx. A dark color represents a larger discrepancy between the two modalities
|No cancer
|Low-risk PCa
|Significant PCa
|Gleason 3 + 3 low volume
|Gleason 3 + 4 low volume
|Gleason 3 + 3 high volume
|Gleason 3 + 4 high volume
|Gleason ≥4 + 3
|No cancer
|Low-risk PCa
|Gleason 3 + 3 low volume
|Gleason 3 + 4 low volume
|Significant PCa
|Gleason 3 + 3 high volume
|Gleason 3 + 4 High volume
|Gleason ≥4 + 3
PCa = prostate cancer.
Reasons for failure of MRI to identify cancer lesions
|Significant PCa
|All lesions
|Lesions detected with TRUS-Bx in all patients
|Lesions detected with MR-Bx in all patients
|negative mpMRI but positive TRUS-Bx
(likely reading failure)
|positive mpMRI but negative MR-Bx and negative TRUS-Bx
(likely reading failure)
|positive mpMRI and positive TRUS-Bx but negative MR-Bx
(likely sampling failure).
PCa = prostate cancer. TRUS-Bx = transrectal ultrasound-guided biopsy. MR-Bx = magnetic resonance image-guided biopsy. mpMRI = multi-parametric MRI.
In 15 patients in which sPCa was detected with TRUS-Bx only, 26 lesions were detected of which 50% (13/26, 95% CI: 31–69%) contained sPCa. In retrospect (with knowledge of the cancer locations from TRUS-Bx) eight lesions could be defined as significant on mpMRI. In three of these sPCa lesions, low-risk cancer was diagnosed with MR-Bx and five sPCa lesions were not seen on the initial detection MRI.
TRUS-Bx detected more lesions (73%, 140/191) compared to MR-Bx (57%, 109/191; 16% difference, 95%CI: 12–21%). However, more lesions were low-risk PCa (28%, 54/191) compared with MR-Bx (2%, 4/191; 26% difference, 95% CI: 20–32%).
The MCCL and TCCL of lesions solitary detected with TRUS-Bx were significantly (p < 0.0001) smaller than MR-Bx biopsy lesions (Table 5). In patients diagnosed with sPCa on MR- and/or TRUS-Bx upgrading of the GS was seen in 41% (58/141) with MR-Bx and in 35% (49/141) with TRUS-Bx (6% difference, 95% CI: 3–11%).
Differences between mean maximum cancer core length (MCCL) and total cancer core length (TCCL) in patients with significant cancer. The p-value of the Wilcoxon-signed rank test is provided
(MR-Bx vs TRUS-Bx)
|All lesions
|Number of missed lesions
|Number of missed significant lesions
|Mean MCCL (mm) of lesions detected with both modalities (SD):
|10.0 (4.6)
|9.5 (4.7)
|Mean TCCL (mm) of lesions detected with both modalities (SD):
|19.6 (12.3)
|24.2 (21.1)
|Mean MCCL (mm) of missed lesions and thus solitary detected with the other modality (SD):
|3.4 (3.4)
|8.6 (4.2)
|Mean TCCL (mm) of missed lesions and thus solitary detected with the other modality (SD)
|6.6 (8.6)
|16.9 (10.2)
MR-Bx = MR-guided biopsy; TRUS-Bx = TRUS-guided biopsy.
Anterior tumor involvement was seen in 31% (44/140, 95% CI: 24–39%) of the sPCa.
3.3. Segment basis
MR- and TRUS-Bx identified 277 and 347 cancer-positive segments respectively in patients with sPCa. The distribution of these segments is shown in Figure 2. With MR- and TRUS-Bx, most cancer-positive segments were located in the midprostate; 53% (147/277, 95% CI: 47–59%) and 37% (128/347, 95% CI: 32–42%), respectively. In total, 39% (109/277, 95% CI: 34–45%) of MR-guided positive segments were located in the anterior part of the prostate.
In lesions with sPCa, MR- and TRUS-Bx missed 97 and 111 segments respectively (Fig. 3). Lesions missed with MR-Bx, which had sPCa detected with TRUS-Bx, appear to be located in the apex (37%, 36/97, 95% CI: 28–47%) and dorsolateral segments (58%, 56/97, 95% CI: 47–67%). Missed sPCa lesions on TRUS-Bx most often had involvement of anterior segments (79%, 88/111, 95% CI: 71–86%). Specifically: anterior midprostate (50%, 56/111, 95% CI: 41–60%) and anterior apex (23%, 25/111, 95% CI: 15–31%).
Distribution maps of the segments of significant prostate cancer lesions that were missed with magnetic resonance image-guided biopsy (MR-Bx; left) and transrectal ultrasound-guided biopsy (TRUS-Bx; right).
SV = seminal vesicles.
4. Discussion
This paper extrapolates on a previously published study, but focuses on lesions missed with MR- and TRUS-Bx. sPCa lesions missed with MR-Bx most often had involvement of the dorsolateral (58%) and apical (37%) segments. With TRUS-Bx, missed sPCa lesions had involvement of segments located anteriorly (79%), anterior midprostate (50%), and anterior apex (23%). Anterior tumor involvement was seen in 41% of the patients, which is consistent with the literature [18]. Lesions localized in the apical region were difficult to detect with both modalities, which is also concordant with the literature [18], [19], [20], and [21].
sPCa is associated with increased age, PSA level, and a small prostate volume [22]. Although not statistically significant, the patient characteristics in our study (Table 1) confirm these relations, but the PSA levels in patients with sPCa detected with TRUS-Bx (Group 2) did not confirm this relation.
mpMRI evaluation can be difficult in the apex given the small size of this region and its location at the margin of the prostate [12]. Also, some focal lesions might be un-noticed on standard DWI protocols due to signal received from surrounding benign prostatic tissue which overshadows the lesion [11]. This may be overcome by using high b-values (1400–2000 s/mm2) [11] and [16]. In our diagnostic protocol we used a calculated b-value of 1400 s/mm2 which may not be sufficient. Furthermore, from the 67 lesions seen on mpMRI which were negative on MR-Bx only three lesions contained sPCa on TRUS-Bx, which suggests these CSLs were false-positive on mpMRI rather than being missed with MR-Bx.
The relatively high involvement of dorsolateral segments in sPCa lesions missed with MR-Bx might be explained by subcapsular tumors [12]. Critical evaluation of small areas with abnormal signal intensity on DWI and dynamic contrast enhanced images in the absence of a readily apparent mass abutting the capsule is recommended [12]. Furthermore, since the exact needle location is not known with TRUS-Bx some lateral biopsy samples can be false-positive. This may occur in cases where the Bx core is located in both the medial and lateral segments but the tumor is confined within the medial segment.
Ukimura et al [2] recommends sampling according to a medial sextant pattern with ≥4 cores from the lateral peripheral zone. Furthermore, this review advises obtaining samples from the anterior apex, anterior lateral horn, and anterior transition zone in the repeat Bx setting [2]. The results found in our study confirm these recommendations.
To our knowledge this is the first study which describes the differences between MR- and TRUS-Bx regarding cancer location in Bx-naïve men at risk for PCa. The results have clinical implications for both radiologists and urologists. For example, to optimize Bx sites for TRUS-Bx and systematic sampling with MRI targeted TRUS-biopsy [23]. Based on our observation it is reasonable to obtain additional samples at initial TRUS-Bx from the anterior apex and anterior midprostate since these are the most common sites where cancer is missed. Adding cores in the extreme anterior apex has been shown to be beneficial [24]. Similarly, it might be reasonable to obtain additional random Bx from dorsolateral and apical regions during mpMRI targeted TRUS-Bx to improve detection of sPCa without the need for systematic 12-core Bx [25].
Regarding costs and patients comfort TRUS-MRI fusion is an interesting alternative for MR-guided Bx [26]. Although there is no study comparing mpMRI targeted TRUS-Bx and in-bore MR-Bx, the visual feedback regarding the accuracy of needle placement makes the in-bore MR-guided biopsy, in our opinion, more accurate.
In our study only 18% of the patients with a PI-RADS 3 lesion on mpMRI had sPCa. This figure was 89% in patients with a PI-RADS 4–5 lesion. Although considerable efforts have been undertaken to determine the optimal threshold for biopsy, this is still a topic of debate [27]. Based on the findings from our study it might be interesting to investigate a region-dependent threshold for biopsy. For example, a threshold of PI-RADS 3 for lesions in the apical and dorsolateral regions and a threshold of PI-RADS 4–5 for lesions elsewhere in the prostate.
Some limitations of this study should be addressed. Firstly, there is no universally accepted and validated definition for sPCa [28]. The modality-specific definition used in our study make the results difficult to compare with other studies. Furthermore, in the case in which a patient has multiple low-risk lesions, this definition can diagnose a patient as having sPCa without having a discrete sPCa lesion. However, this definition was created to allow comparison of two to four MR-Bx cores with 12-cores obtained with TRUS-Bx.
Secondly, whole mount prostatectomy would be the most reliable tool for histopathologic evaluation but is ethically impossible in patients with no proven cancer on biopsy. An alternative approach is to use 5-mm transperineal template prostate mapping [4]. The need for general anesthesia and increased complication rate makes this a highly invasive technique and presents challenges in recruiting patients for clinical trials when less invasive alternatives are available [4].
Thirdly, a subanalysis of patients who underwent prostatectomy would provide an excellent reference standard; however, this may have introduced selection bias. By comparing the Bx results between MR- and TRUS-Bx we were able to directly compare differences between these modalities in a large patient group.
5. Conclusions
Both MR- and TRUS-Bx have difficulties in detecting apical lesions. MR-Bx most often missed cancer with involvement of the dorsolateral part (58%) and TRUS-Bx missed lesions with involvement of the anterior part (79%).
Author contributions: Martijn Gerjan Schouten had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Schouten, van der Leest, Futterer, Barentsz.
Acquisition of data: Schouten, van der Leest, Pokorny, Thompson, Barentsz, Futterer.
Analysis and interpretation of data: Schouten, van der Leest, Futterer.
Drafting of the manuscript: van der Leest, Schouten, Pokorny, Hoogenboom, Barentsz, Thompson, Futterer.
Critical revision of the manuscript for important intellectual content: Barentsz, Futterer, Thompson.
Statistical analysis: Schouten, Futterer.
Obtaining funding: Futterer, Barentsz.
Administrative, technical, or material support: Thompson, Barentsz.
Supervision: Barentsz, Futterer.
Other: None.
Financial disclosures: Martijn Gerjan Schouten certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: None.
Funding/Support and role of the sponsor: The Dutch Cancer Society.
- [1] S. Loeb, M.A. Bjurlin, J. Nicholson, et al. Overdiagnosis and overtreatment of prostate cancer. Eur Urol. 2014;65:1046-1055 Crossref
- [2] O. Ukimura, J.A. Coleman, A. de la Taille, et al. Contemporary role of systematic prostate biopsies: indications, techniques, and implications for patient care. Eur Urol. 2013;63:214-230 Crossref
- [3] V. Scattoni, C. Maccagnano, U. Capitanio, A. Gallina, A. Briganti, F. Montorsi. Random biopsy: when, how many and where to take the cores?. World J Urol. 2014;32:859-869 Crossref
- [4] A. Sivaraman, R. Sanchez-Salas, E. Barret, et al. Transperineal template-guided mapping biopsy of the prostate. Int J Urol. 2015;22:146-151 Crossref
- [5] N. Bittner, G.S. Merrick, W.M. Butler, A. Bennett, R.W. Galbreath. Incidence and pathological features of prostate cancer detected on transperineal template guided mapping biopsy after negative transrectal ultrasound guided biopsy. J Urol. 2013;190:509-514 Crossref
- [6] A.B. Rosenkrantz, S.S. Taneja. Prostate MRI can reduce overdiagnosis and overtreatment of prostate cancer. Acad Radiol. 2015;22:1000-1006 Crossref
- [7] J.J. Futterer, A. Briganti, P. De Visschere, et al. Can clinically significant prostate cancer be detected with multiparametric magnetic resonance imaging?. A systematic review of the literature. Eur Urol. 2015;68:1045-1053 Crossref
- [8] J.E. Thompson, P.J. van Leeuwen, D. Moses, et al. The diagnostic performance of multiparametric magnetic resonance imaging to detect significant prostate cancer. J Urol. 2016;195:1428-1435 Crossref
- [9] M. Abd-Alazeez, A. Kirkham, H.U. Ahmed, et al. Performance of multiparametric MRI in men at risk of prostate cancer before the first biopsy: a paired validating cohort study using template prostate mapping biopsies as the reference standard. Prostate Cancer Prostatic Dis. 2014;17:40-46
- [10] A. Sivaraman, R. Sanchez-Salas, H.U. Ahmed, et al. Clinical utility of transperineal template-guided mapping biopsy of the prostate after negative magnetic resonance imaging-guided transrectal biopsy. Urol Oncol. 2015;33:329 e7-11
- [11] A.B. Rosenkrantz, S.S. Taneja. Radiologist, be aware: ten pitfalls that confound the interpretation of multiparametric prostate MRI. AJR Am J Roentgenol. 2014;202:109-120 Crossref
- [12] A.B. Rosenkrantz, S. Verma, B. Turkbey. Prostate cancer: top places where tumors hide on multiparametric MRI. AJR Am J Roentgenol. 2015;204:W449-W456 Crossref
- [13] M.R. Pokorny, M. de Rooij, E. Duncan, et al. Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol. 2014;66:22-29 Crossref
- [14] J.O. Barentsz, J. Richenberg, R. Clements, et al. ESUR prostate MR guidelines 2012. Eur Radiol.. 2012;22:746-757 Crossref
- [15] T. Hambrock, J.J. Futterer, H.J. Huisman, et al. Thirty-two-channel coil 3T magnetic resonance-guided biopsies of prostate tumor suspicious regions identified on multimodality 3T magnetic resonance imaging: technique and feasibility. Invest Radiol. 2008;43:686-694 Crossref
- [16] J.O. Barentsz, J.C. Weinreb, S. Verma, et al. Synopsis of the PI-RADS v2 Guidelines for multiparametric prostate magnetic resonance imaging and recommendations for use. Eur Urol. 2016;69:41-49 Crossref
- [17] L. Dickinson, H.U. Ahmed, C. Allen, et al. Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. Eur Urol. 2011;59:477-494 Crossref
- [18] G.A. Abdelsayed, T. Danial, J.A. Kaswick, D.S. Finley. Tumors of the anterior prostate: implications for diagnosis and treatment. Urol. 2015;85:1224-1228 Crossref
- [19] Z. Mai, W. Yan, Y. Zhou, et al. Transperineal template-guided prostate biopsy: 10 years of experience. BJU Int. 2016;117:424-429 Crossref
- [20] V. Iremashvili, L. Pelaez, M. Jorda, et al. Prostate sampling by 12-core biopsy: comparison of the biopsy results with tumor location in prostatectomy specimens. Urology. 2012;79:37-42 Crossref
- [21] N. Tan, D.J. Margolis, D.Y. Lu, et al. Characteristics of detected and missed prostate cancer foci on 3-T multiparametric MRI Using an endorectal coil correlated with whole-mount thin-section histopathology. AJR Am J Roentgenol. 2015;205:W87-W92 Crossref
- [22] X. Zhu, P.C. Albertsen, G.L. Andriole, M.J. Roobol, F.H. Schroder, A.J. Vickers. Risk-based prostate cancer screening. Eur Urol. 2012;61:652-661 Crossref
- [23] S.S. Salami, E. Ben-Levi, O. Yaskiv, et al. In patients with a previous negative prostate biopsy and a suspicious lesion on magnetic resonance imaging, is a 12-core biopsy still necessary in addition to a targeted biopsy?. BJU Int. 2015;115:562-570 Crossref
- [24] A.S. Moussa, A. Meshref, L. Schoenfield, et al. Importance of additional "extreme" anterior apical needle biopsies in the initial detection of prostate cancer. Urology. 2010;75:1034-1039 Crossref
- [25] I.G. Schoots, M.J. Roobol, D. Nieboer, C.H. Bangma, E.W. Steyerberg, M.G. Hunink. Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis. Eur Urol. 2015;68:438-450 Crossref
- [26] M.A. Bjurlin, N. Mendhiratta, J.S. Wysock, S.S. Taneja. Multiparametric MRI and targeted prostate biopsy: Improvements in cancer detection, localization, and risk assessment. Cent European J Urol. 2016;69:9-18
- [27] E.H. Hamoen, M. de Rooij, J.A. Witjes, J.O. Barentsz, M.M. Rovers. Use of the Prostate Imaging Reporting and Data System (PI-RADS) for prostate cancer detection with multiparametric magnetic resonance imaging: a diagnostic meta-analysis. Eur Urol. 2015;67:1112-1121 Crossref
- [28] G. Ploussard, J.I. Epstein, R. Montironi, et al. The contemporary concept of significant versus insignificant prostate cancer. Eur Urol. 2011;60:291-303 Crossref
a Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
b Department of Urology, The Wesley Hospital, Brisbane, Australia
⁎ Corresponding author. Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Geert Grooteplein 10, Nijmegen 6525 GA, The Netherlands. Tel. +31 24 365 22 79.
Article information
DOI: 10.1016/j.eururo.2016.12.006
© 2016 European Association of Urology, Published by Elsevier B.V.


text:
INVESTOR or BUILDER Alert! Lowest priced Acre lot @ $51.22 per square foot in ELGIN/CHANTRELL. Zoned RA, this gorgeous 1.077 Acre lot faces West. Ideal site for those with vision seeking a quiet private retreat where you can create your very own family resort. The purchase price includes architecturally designed house plans by "Willson Design" for an estate style 9300+ sq foot. Imagine linear lines, concrete & glass, outdoor pool with cascading water feature & 8 car garage. Demolitions permits were obtained to clear the old structure and an Arborist report is available. Build your dream home on this exceptional lot that's close to the water and surrounded by estate like homes! Call for more details.
Taxes (2017): $7,885.15


text:
Soaked basements. Saturated fields. Ruined cars. Snapped power lines. Broken bridges and collapsed roadways. From coast to coast, Michigan's communities struggle with extreme storms, high water levels, and flooding. The resulting damage can cripple communities and ruin livelihoods.
As climate change leads to more frequent and more severe storms in Michigan, it's more important than ever to be aware and prepared for potential hazards from storms and flooding.
Other hazards associated with extreme storms and flooding
In addition to damaging homes, businesses, power lines, agricultural fields, roadways, and other infrastructure, extreme storms and floods can also:
- Wash high levels of nitrogen, phosphorus, and other nutrients into rivers and streams, where they can lead to harmful algal blooms.
- Give invasive fish and plant species new routes for moving from one water body to another.
- Create damp environments that encourage the growth of mildew, mold, harmful bacteria, and mosquito larvae.
- Tempt people to swim, fish, wade, or boat in potentially hazardous waters. Fast-moving currents, underwater obstructions, and waterborne contaminants can all threaten the health and safety of people who take risks in floodwaters.
Michigan Sea Grant coastal storms project
Michigan Sea Grant's Coastal Storms Project is helping communities prepare for future extreme storms. Click here to read more about the project.
Michigan Sea Grant has identified some tips and online tools to help communities assess their risks from extreme storms and determine what steps they might take to reduce stormwater impact:
- Extreme storms in the Saginaw Bay region impact public health, community safety, and economic stability (PDF)
- Tools to increase awareness of stormwater during extreme storms (PDF)
- Tools to assess risks from extreme storms in the Saginaw Bay region (PDF)
The Great Flood of 1986
In 1986, Michigan experienced a devastating storm and flood event. Michigan Sea Grant and partners have collected stories and photographs from people who experienced the historic flooding, particularly in the hard-hit Saginaw Bay region. Click here to learn more.
Disasters like the 1986 flood can teach us lessons about preparing for and coping with future storms. Click here for resources and tools.
From Michigan State University Extension
Michigan State University Extension has a wealth of resources for farmers and homeowners facing floodwaters and storms:
- Should I be worried if flood waters reach my well?
- Repairing your flood-damaged fields
- Evaluating hail-damaged crops – Part 1
- Evaluating flood-damaged crops – Part 2
- Evaluating wind-damaged crops – Part 3
- Food safety issues to consider after a flood
- Trees and flooding FAQs
- Mid-Michigan flood resource page


text:
Listing of all hotels in Bagno Di Romagna, Italy. Click on the name or picture of a hotel for more information about that Bagno Di Romagna hotel. There's also a Bagno Di Romagna hotel search form to request a listing of all hotels in Bagno Di Romagna with rooms available on your dates of travel.
Compare prices for the best hotel deals in Bagno Di Romagna:
On line travel magazine Off The Beaten Trackoffers travelogues about Italy:
Travelogue City trip Rome(A capital of culture)
Cheap hotel reservations > Italy > Bagno Di Romagna


text:
About us
Purpose & Vision
In an era when orchestras across America are struggling for survival, The Norman Philharmonic and the City of Norman, Oklahoma will present a variety of wonderfully imaginative concerts.
Our Goals
- To establish an innovative and standard-setting chamber orchestra capable of performing a variety of music - from classical to jazz to contemporary
- To commission new works from American composers
- To establish Norman, Oklahoma as the center of excellence in the arts
- To excite the youth of Oklahoma about symphonic music
According to the report, "Arts Participation 2008: Highlights from a National Survey," attendance at non-musical plays, opera, and jazz concerts has fallen to its lowest level since 1982, the first year of the survey. Over that period of time, the fine arts and the humanities have also drawn special scrutiny in the ongoing debate over the national debt, with many characterizing them as frivolous luxuries, or even attacking them as elitist. Indeed, bills introduced in Congress this year propose either severe cuts to the budgets of the National Endowments for the Arts and the Humanities, or their elimination.
Many reasons can be cited for the decline of public interest in supporting and participating in the arts and humanities, but we do not need a survey to tell us that traditional methods of teaching, performance and presentation no longer capture the interest of a public that has access to streaming media on their phones and 3D movies with surround-sound via their home theaters. We must define a new approach to presenting music that can spark public interest and bring people back to church, theaters and performance halls.
The Norman Philharmonic's innovative approach to music combined with existing music festivals, the OU Arts district and the Sooner Theater will foster growth in education and business both in Norman and the surrounding communities.


text:
Since I deactivated my OKCupid account, I have been contacted by considerably fewer ignorant dicks looking to score. However, I still have a personal Fetlife account, and that still nets me a couple messages from horny strangers every month or so.
Erica Grigg, one of the founders of GetLusty.com (which I write for, and which you should read) posted a Facebook status saying that she hated getting hit on by "stupid men who don't read her profile." Erica is married, and it's pretty apparent that she's monogamous. The man that sparked this status messaged her to say, "You look gorgeous… i will love to connect with you on here, get to know each other better and see where it goes from here."
From the tone of her status, Erica sounded pretty annoyed. I can't blame her. I'm annoyed every time I get a message like that. Don't get me wrong – I've never bitten anyone's head off for hitting on me, but heaven knows that I've wanted to whenever someone does it the wrong way. Let me assure you, there is a difference. Today you're going to learn about the wrong way to hit on someone, and then I'm going to give you five easy ways to send a message that someone will want to respond to.
Mistake #1:
You don't read their profile.
Who gets on a dating website and doesn't read someone's profile? Are you really that desperate? Are your standards really that low that you don't care who you have sex with? Maybe there's some strategy in playing the odds… after all, statistically, the more people you message, the more people you should get a response from, right? Well that's not going to happen if you try to sow your oats in the wrong fields.
Reading someone's profile has many benefits. For starters, reading a profile gives you an opportunity to determine whether you'll be able to pretend to like them long enough to bone them. Or maybe you'll realize that you actually want to get to know them. But it gives you something to talk about, and more importantly, it keeps you from making…
Mistake #2:
Messaging someone when it's never going to happen.
This isn't me having a defeatist attitude. This is a huge example of trying to sow your oats in the wrong fields. There are circumstances that absolutely preclude you hooking up with your target.
Is your target in a relationship and monogamous? Chances are that you're wasting your time.
Are you a man messaging a lesbian? WHY DO YOU THINK THAT IS A GOOD IDEA? Do you just look at someone's sex and profile picture and start messaging? My ex's OKCupid and Fetlife profiles both said lesbian, and yet the messages from men kept flooding in.
Just don't do it. Unless you're on a dating website for people looking to cheat on their monogamous partners, don't message monogamous coupled people. Thinking about messaging that lesbian to see if she wants to suck your dick? Take your head and slam it vigorously against a wall, then see if that still seems like a good idea.
Mistake #3:
You send a one (or two, in some cases) line message… or you don't send a message, and just send a picture instead.
There are plenty of ways to do this wrong, and there are almost never situations in which you'll get a response when you do this.
Doing it wrong:
"Hi beautiful, would love to get together with you." "Hi sexy, would love to connect and see where it goes." Etc.
Why it's wrong:
I'm sure that when you're writing that message, it seems pretty harmless. But when I receive that message, I have a few different feelings all at once.
- I feel like you're using a word like "beautiful" or "sexy" to objectify me, assert dominance over me, and condescend to me. It doesn't feel like a compliment, it feels like you're two steps away from sitting me down and mansplaining something to me.
- I feel like the compliment is artificial and is only there because you think that the only way to speak to a woman is by talking about her physical appearance.
- If you have never seen me, then I am immediately angered by your assumption that I am attractive. It implies that you're desperate and/or have no standards.
- When you say something like, "See where it goes…" or, "See what happens…" I know where it's going: nowhere. What you have implied to me is not that you want to get to know me as a person – you have implied that your only interest in me is the sex you think you're going to get.
Doing it wrong:
"You are so sexy."
Why it's wrong:
You haven't started a conversation with me at all. You have indicated that all you care about is my physical appearance.
Doing it wrong:
" l'll be they guy you do butt drop and facesitting on…" or anything else sexually explicit
Why it's wrong:
I actually got that message on Fetlife. I don't even know what a butt drop is. It's not the first explicit message I've received, and probably won't be the last. You'll have to excuse me if I don't get moist the instant a stranger offers to choke me with his dick.
Doing it wrong:
Pictures of yourself naked or of your genitalia.
Why it's wrong:
If I have to explain this for you, end your search now. You are clueless and you will die alone.
Mistake #4:
You don't have a profile picture or any information in your profile.
Maybe you were just so eager to hook up that you forgot to upload a photo or write a few lines about yourself in your profile. Maybe you didn't know what to say, or you weren't satisfied with any of the photos you had. Refrain from messaging anyone until you have written a profile and put up a photo.
If you have a profile but no picture, then your blank user picture is a question that I want an answer to. "That's shallow," you say! Is it really so shallow for me to want to avoid meeting someone that I'll recognize from America's Most Wanted? ? If you don't have a picture but I do, you have me at a disadvantage. I'm not okay with that.
If you have a picture but no information in your profile, then my mind automatically fills in your profile for you.
And if you don't have any information – no profile, no photo, nothing – then you don't even register as a person to me. You're a ghost in the machine. An annoying ghost with bad spelling.
Mistake #5:
You don't drop it once you're told to bug off.
After a response declining his advances, one man who messaged my ex said, "So you don't want to hook up?" My ex responded, "That's generally what lesbian means." If I recall correctly, the dude didn't stop sending messages.
Persistence isn't your friend when you're rejected. Ten more messages aren't going to change someone's sexuality, make them any less single, or make you any more interesting or attractive. Ten more messages are going make you look pathetic, and they're going to get you blocked and reported. And if someone doesn't respond, there's no need to send an inflammatory message – it's totally unnecessary, and it's definitely not charming.
Harassment isn't sexy. Once I've told you that I'm not interested, please don't keep messaging me. Even if you think your messages are friendly ("But you're so pretty! I'm really interested, are you sure?"), they show me that you're incapable of respecting my wishes. If you'll ignore me when I tell you to stop messaging me, will you ignore me when I tell you to stop following me, or to stop trying to have sex with me? It's unsettling. Leave me alone and move on.
Doing it right:
1. Find the right site. Facebook isn't a dating site. Don't try to hook up with people you barely know on Facebook. Try to find a site that caters to your needs. Is religion a big part of your life? Try ChristianMingle or JDate. Looking for a basic dating site? OKCupid works. PlentyOfFish exists. Kinky? Use Alt.com or something. (I'm not saying that Fetlife can't find you a date, but it is not, by definition, a dating site. So stop messaging me like it is.)
2. Take a nice photo of yourself. A photo with your face in it. We don't care about your bare chest or your genitals.
3. Fill out all the sections of your profile, and try to make it interesting. Don't lie. Let your personality shine through. We want to know who you are and what you have to say about yourself. If you just talk about your career and list your interests, you've only given us the equivalent of what we could have learned by hunting you down on Facebook. Do you feel like you know someone when you've only read someone's work info and the list of things they liked? If you do, you might have issues – those things don't tell you who someone really is. They definitely don't tell you whether you're going to like someone.
4. Read someone's profile. It contains vital information: gender, sexuality, relationship status. It also contains the information you need to send a message that's actually going to get a response: hobbies and interests.
5. Compose a message. Try to make it more than one line. I'm not asking you to write someone a novel, but make it a message that's worth the click it takes to open it. Aim for at least three sentences. Don't use terms of endearment in your first message to someone. If you're going to give a compliment, give it in a full sentence: "You have a beautiful profile picture." instead of, "Hey beautiful."
Ask questions so that the person you're messaging has a reason to message you back. Don't include anything sexually explicit, because it's just not sexy and it's going to discourage someone from responding to you at all, let alone to say, "Buzz off." Spell check your message before you send it. The easier it is to read what you've written, the more likely someone is to respond.
Ta-da! You have sent your first message worth reading.
Welcome to the world of people who receive responses.
Fellow victims of unwelcome digital advances, I would love to hear your horror stories. What's the most absurd message you've ever received?


text:
Eight Manchester United players were among the 23 people killed in a tragedy that also claimed the life of Frank Swift, the former Manchester City and England goalkeeper, who had travelled to United's fateful European Cup tie against Red Belgrade in his role as a correspondent with the News of the World.
City are in Munich to play Bayern in their first away fixture in the Champions League and the idea from senior figures within the club, led by chairman Khaldoon al Mubarak, was to make a tribute to try and diffuse increasingly hostile relations between the two sets of fans.
United manager Ferguson earlier gave credit to City for the gesture.
"It's refreshing." Ferguson said. "We appreciate that from Manchester City.
"Of course, one of their former players [Swift] was killed in the crash, but it's a sign the game is [football] is not as bad as sometimes we think.
"Sometimes the supporters' contribution is not nice, but we appreciate that."
The event was deliberately low key and saw the delegation, including Tony Book, former City manager, Bernard Hatford, Life President, Brian Marwood and Kidd lay a simple wreath at the memorial stone in memory of the victims.